Differin (Adapalene)
Class and Category of Drug
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Chemical class: Thiuram derivative
Therapeutic class: Alcohol abuse deterrent
Pregnancy category: Not rated
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Drug Indications and Dosages
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As adjunct to maintain sobriety in treatment of chronic alcoholism
Tablets
Adults. Initial: Up to 500 mg daily for 1 to 2 wk. Maintenance: 125 to 500 mg daily. Maximum: 500 mg daily.
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Contraindications of Drug
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Alcohol intoxication; coronary artery occlusion; hypersensitivity to disulfiram, its components, rubber, pesticides, or fungicides; psychosis; recent use of alcohol, alcohol-containing preparations, metronidazole, or paraldehyde; severe myocardial disease
Generic Drug Interactions
Drugs
alfentanil: Decreased plasma clearance and prolonged duration of action of alfentanil amoxicillin-clavulanate, bacampicillin: Possibly disulfiram-alcohol reaction
ascorbic acid: Possibly interference with disulfiram-alcohol reaction
CNS depressants: Possibly increased CNS depressant effects of either drug
isoniazid: Increased risk of additive neurotoxic effect of disulfiram; possibly increased adverse CNS effects
metronidazole: Risk of CNS toxicity, resulting in confusion and psychosis
oral anticoagulants: Possibly increased anticoagulant effects
paraldehyde: Decreased paraldehyde metabolism, increased blood paraldehyde level
phenytoin: Possibly increased blood phenytoin level and risk of phenytoin toxicity
tricyclic antidepressants: Possibly temporary delirium
Foods
caffeine: Possibly increased cardiovascular and CNS effects of caffeine
Activities
alcohol use: Disulfiram-alcohol reaction (if within 14 days of disulfiram therapy)
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Drugs Adverse Reactions
Central Nervous System: Drowsiness, headache, peripheral neuropathy, psychotic reaction, tiredness
Eyes, Ears, Nose, And Throat: Blurred vision, garlic or metallic taste, optic atrophy, optic neuritis
Genitourinary: Impotence
Skin: Rash
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Nursing Considerations for Generic Drugs
• Disulfiram is given only to patients who are highly motivated to stop drinking and who are receiving psychotherapy or substance abuse counseling.
•Alcohol content of patient's other drugs should be checked before starting therapy.
• If needed, crush tablet and mix with fluids before administration.
• Don't give drug within 14 days of patient's ingestion of alcohol-containing substance.
• Expect alcohol ingestion during disulfiram therapy to produce a severe reaction that lasts from 30 minutes to several hours. Symptoms may include angina, anxiety, blurred vision, confusion, diaphoresis, dyspnea, heart failure, hypotension, nausea, palpitations, sinus tachycardia, syncope, thirst, throbbing headache, throbbing in neck, vertigo, vomiting, and weakness. A deep sleep usually follows.
WARNING Never give drug to patient without her knowledge or who is intoxicated.
WARNING Ingestion of three or more alcoholic beverages with a disulfiram dose greater than 500 mg daily may cause respiratory depression, arrhythmias, and cardiac arrest.
• If patient takes phenytoin, monitor blood phenytoin level before and during disulfiram therapy, and adjust dosage of either drug as prescribed. Interactions may not occur if disulfiram therapy starts before phenytoin therapy. A subtherapeutic phenytoin level may result if disulfiram therapy stops.
• If patient takes an oral anticoagulant, monitor prothrombin time before and during disulfiram therapy, and adjust anticoagulant dosage as prescribed. Drug interactions may not occur if disulfiram therapy starts before warfarin therapy. If disulfiram therapy stops, be prepared to adjust warfarin dosage to avoid loss of hypoprothrombinemic effects.
• Expect some adverse reactions, such as drowsiness, headache, and impotence, to subside over time or with a brief dosage reduction.
• Because one-fifth of a disulfiram dose may stay in the body for 1 week or longer, alcohol ingestion may continue to produce unpleasant symptoms for up to 2 weeks after therapy stops.
• Expect therapy to last months to years, depending on patient's ability to abstain from alcohol.
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Adapalene
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
Proprietary Preparations
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